Early Menarche: Is it a Risk Factor
for Depression, Substance Abuse,
and Eating Disorders?
Facilitator: Ann Hung, Mental Health Board Intern
June 8th, 2011
Agenda
1. Early puberty
2. Biological, environmental, and nutritional
aspects
3. Stress hypotheses
4. Negative psychosocial outcomes:

Depression
 Substance Use
 Eating Pathology
5. Limitations of research and implications for
clinical practice
Puberty

Are girls developing
earlier than before?

(Herman-Giddens et al., 1997;
Walvoord, 2010)

Pubarche, thelarche &
menarche

Ethnic differences in
onset of puberty

(Obeidallah et al., 2000;
Chumlea et al., 2003)
Biological and Environmental
Antecedents

Biological



genes (Brooks-Gunn & Warren, 1988)
Environmental

poverty

father absence (Surbey, 1990; Deardorff et al., 2011)

family conflict
Nutrition and Obesity (Kaplowitz et al., 2001; Davidson et al., 2003)
Stress Hypotheses
(Caspi & Moffitt, 1991)
1. Stressful Change
2. Off-time
3. Early-Timing
Total Behavior Problem Score (RBPC)
Caspi & Moffitt, 1991
Behavior Problems as a function of age at menarche
25
20
<12
12-13
13-14
14-15
15
10
5
0
13
Age
15
Depression


Theoretical Underpinnings

physical changes

hormonal changes
Comorbidity with other disorders (Patton et al., 1996;
Hayward et al., 1996; Graber et al., 2004)

Results among racial minorities

(Hayward et al., 1999)

(Ge et al., 2003)
Eating Pathology

Two central mechanisms (Stice & Shaw, 2002)

dieting

negative affect

Mixed findings re. early menarche on eating pathology

Other factors leading to eating disorders
Precursors and Consequences of Body
Dissatisfaction
Substance Use


Early maturers → increased risk of substance
use (Dick et al., 2000)
Association of girls with older peers (Magnusson et al.,
1986; Moffitt et al., 2001)

Means for self-medication

Racial Differences

cigarette use (Negriff et al., 2010)
Limitations of Current Literature

Lack of follow-up reports

Retrospective data

Measurement criterion

Dearth of racially diverse samples
Implications for Clinical Practice


Spending more time on body dissatisfaction

sociocultural ideals of thinness

critical consumers of mass media
Intervention programs targeted during the most
developmentally challenging and stress
inducing times

Informational programs for parents

5th vital sign
References
Belsky, J., Steinberg, L., & Draper, P. (1991). Childhood experience, interpersonal development and reproductive strategy:
An evolutionary theory of socialization. Child Development, 62, 647-670.
Brooks-Gunn, J., & Warren, M. P. (1989). Biological and social contributions to negative affect in young adolescent girls.
Child Development, 60, 40-55.
Caspi, A., & Moffitt, T. E. (1991). Individual differences are accentuated during periods of social change: The sample case
of girls at puberty. Journal of Personality and Social Psychology. Vol 61(1), 61, 157-168.
Chumlea, W. C., Schubert, C. M., Roche, A. F., Kulin, H. E., Lee, P. A., Himes, J. H., & Sun, S. S. (2003). Age at Menarche
and Racial Comparisons in US Girls. Pediatrics, 111(1), 110 -113. doi:10.1542/peds.111.1.110
Deardorff, J., Ekwaru, J. P., Kushi, L. H., Ellis, B. J., Greenspan, L. C., Mirabedi, A., Landaverde, E. G., et al. (2011).
Father Absence, Body Mass Index, and Pubertal Timing in Girls: Differential Effects by Family Income and Ethnicity.
Journal of Adolescent Health, 48(5), 441-447. doi:10.1016/j.jadohealth.2010.07.032
Dick, D. M., Rose, R. J., Viken, R. J., & Kaprio, J. (2000). Pubertal timing and substance use: Associations between and
within families across late adolescence. Developmental Psychology. Vol 36(2), 36, 180-189.
Ge, X., Kim, I. J., Brody, G., Conger, R. D., & Simons, R. L., (2003). It's about timing and change: Pubertal transition
effects on symptoms of major depression among African American youths. Developmental Psychology, 39, 430-439.
Graber, J. A., Seeley, J. R., Brooks-Gunn, J., & Lewinsohn, P. M. (2004). Is pubertal timing associated with
psychopathology in young adulthood? Journal of the American Academy of Child and Adolescent Psychiatry, 43, 718726.
Hayward, C., Gotlib, I. H., Schraedley, P. K., & Litt, I. F. (1999). Ethnic differences in the association between pubertal
status and symptoms of depression in adolescent girls. Journal of Adolescent Health, 25(2), 143-149.
doi:10.1016/S1054-139X(99)00048-8
References cont.
Herman-Giddens, M. E., Wasserman, R. C., Bourdony, C. J., Bhapkar, M. V., Koch, G. G., & Hasemeier, C. M. (1997).
Secondary sexual characteristics and menses in young girls seen in office practice: A study from the pediatric
research in office settings network. Pediatrics, 4, 505-512.
Kaplowitz, P. B., Slora, E. J., Wasserman, R. C., Pedlow, S. E., & Herman-Giddens, M. E. (2001). Earlier onset of puberty
in girls: Relation to increased body mass index and race. Pediatrics, 108(2), 347-353.
Magnusson, D., Stattin, H., & Allen, V. L. (1986). Biological maturation and social development: A longitudinal study of
some adjustment processes from midadolescence to adulthood. Journal of Youth and Adolescence, 14, 267-283.
Negriff, S., Dorn, L. D., & Huang, B. (2010). Pubertal timing and smoking initiation in adolescent females: Differences by
race. Nicotine & Tobacco Research. Vol 12(7), 12, 748-755.
Obeidallah, D. A., Brennan, R. T., Brooks-Gunn, J., Kindlon, D., & Earls, F. (2000). Socioeconomic Status, Race, and Girls’
Pubertal Maturation: Results From the Project on Human Development in Chicago Neighborhoods. Journal of
Research on Adolescence, 10(4), 443. doi:10.1207/SJRA1004_04
Stice, E., & Shaw, H. E. (2002). Role of body dissatisfaction in the onset and maintenance of eating pathology: A synthesis
of research findings. Journal of Psychosomatic Research, 53(5), 985-993. doi:16/S0022-3999(02)00488-9
Walvoord, E. C. (2010). The timing of puberty: Is it changing? Does it matter? Journal of Adolescent Health. Vol 47(5), 47,
433-439.
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Girls Who Aggress & Early Menarche